Improvement of motor performance by observational training in elderly people

Effect of community-based group exercises combined with action observation on physical and cognitive performance in older adults during the Covid-19 pandemic: A randomized controlled trial

OBJECTIVE

This study investigates the impact of community-based exercises with action observation therapy (AOT) on the physical and cognitive performance of older adults experiencing social isolation during the COVID-19 pandemic.

METHODS

One hundred participants aged 65-80 years were randomly divided into two groups: the AOT group, which engaged in balance, strengthening, and mobility exercises guided by 15-minute action observation videos before a 45-minute exercise session, and the control group, which performed the same exercises without action observation. Both groups underwent three sessions per week for eight weeks (24 sessions in total). The assessment tools used in this study included the following: For evaluating mobility and fall risk in older adults, the Timed Up-and-Go (TUG) Test was employed. To assess functional strength of lower extremities, balance, and fall risk, the Five Times Sit-to-Stand (5XSST) Test was administered. Balance and gait were measured using the Tinetti Balance and Gait Assessment (TBGA), utilizing the Tinetti Scale. Individuals' confidence in performing daily activities without falling or losing balance was assessed using the Activities-Specific Balance Confidence Scale (ABC). Furthermore, cognitive functions across multiple domains, including attention-concentration, executive function, memory, language, visual construction skills, abstract thinking, calculation, and orientation, were evaluated using the Montreal Cognitive Assessment (MoCA) Tests.

RESULTS

Results revealed significant improvements in both groups. Group I, which received Action Observation Therapy (AOT) in addition to exercise, demonstrated superior outcomes in the 5XSit-to-Stand test (Δ = -1.92, p < 0.0001, Cohen's d = 0.77), Tinetti Balance and Gait Scale (Balance: Δ = 2.77, p < 0.0001, Cohen's d = 0.91), and Timed Up and Go test (Δ = -1.98, p < 0.0005, Cohen's d = 0.83). On the other hand, Group II, which received exercise only, exhibited substantial gains in the Tinetti Balance and Gait Scale (Walking: Δ = 0.52, p < 0.01, Cohen's d = 0.27) and Activity-Specific Balance Confidence Scale (Δ = 5.77, p < 0.0001, Cohen's d = 0.26).

CONCLUSION

These findings underscore the effectiveness of AOT-enhanced community-based exercises in enhancing both physical and cognitive performance among older adults facing social isolation during the pandemic, with Group I (AOT + exercise) showing particularly promising results.

TRIAL REGISTRATION

This study was registered with ClinicalTrials.gov Identifier: NCT04759690, ClinicalTrials Protocol ID: p3957ghb.

Observation and motor imagery balance tasks evaluation: An fNIRS feasibility study

In this study, we aimed at exploring the feasibility of functional near-infrared spectroscopy (fNIRS) for studying the observation and/or motor imagination of various postural tasks. Thirteen healthy adult subjects followed five trials of static and dynamic standing balance tasks, throughout three different experimental setups of action observation (AO), a combination of action observation and motor imagery (AO+MI), and motor imagery (MI). During static and dynamic standing tasks, both the AO+MI and MI experiments revealed that many channels in prefrontal or motor regions are significantly activated while the AO experiment showed almost no significant increase in activations in most of the channels. The contrast between static and dynamic standing tasks showed that with more demanding balance tasks, relative higher activation patterns were observed, particularly during AO and in AO+MI experiments in the frontopolar area. Moreover, the AO+MI experiment revealed a significant difference in premotor and supplementary motor cortices that are related to balance control. Furthermore, it has been observed that the AO+MI experiment induced relatively higher activation patterns in comparison to AO or MI alone. Remarkably, the results of this work match its counterpart from previous functional magnetic resonance imaging studies. Therefore, they may pave the way for using the fNIRS as a diagnostic tool for evaluating the performance of the non-physical balance training during the rehabilitation period of temporally immobilized patients.

The role of mirror mechanism in the recovery, maintenance, and acquisition of motor abilities

While it is well documented that the motor system is more than a mere implementer of motor actions, the possible applications of its cognitive side are still under-exploited, often remaining as poorly organized evidence. Here, we will collect evidence showing the value of action observation treatment (AOT) in the recovery of impaired motor abilities for a vast number of clinical conditions, spanning from traumatological patients to brain injuries and neurodegenerative diseases. Alongside, we will discuss the use of AOT in the maintenance of appropriate motor behavior in subjects at risk for events with dramatic physical consequences, like fall prevention in elderly people or injury prevention in sports. Finally, we will report that AOT can help to tune existing motor competencies in fields requiring precise motor control. We will connect all these diverse dots into the neurophysiological scenario offered by decades of research on the human mirror mechanism, discussing the potentialities for individualization. Empowered by modern technologies, AOT can impact individuals' safety and quality of life across the whole lifespan.

Feasibility of action observation effect on gait and mobility in idiopathic normal pressure hydrocephalus patients

Action observation (AO) has been proved to be of benefit in several neurological conditions, but no study has previously been conducted in idiopathic normal pressure hydrocephalus (iNPH).

Effects of Otago exercise combined with action observation training on balance and gait in the old people

This study aimed to investigate the effects of Otago exercise combined with action observation (AO) training on the balance, and gait in the old people to prevent falls in the community. A total of 30 old women participated and randomly assigned into three groups: AO plus Otago (n=10), Otago (n=10), or control (n=10). The AO plus Otago and Otago groups performed 50 min of strength training and balance exercises from the Otago Exercise Program 3 times a week for 12 weeks. The AO plus Otago group received an additional 20 min of training 3 times a week. We used the electronic muscle dynamometer to changes in strength, Timed Up and Go (TUG) test to evaluate dynamic balance, and the short version of the Falls Efficacy Scale-International was used to evaluate the fear of falls, and GAITRite was used to evaluate changes in the spatiotemporal parameters of walking. The muscle strength significantly increased in the AO plus Otago and Otago groups compared to the strength before training. The TUG test showed a significant improvement in the dynamic balance in both intervention groups. A significant increase was observed in the walking speed, cadence, step length, and stride length in both intervention groups. We also noted a significant change in the efficacy measures for falls. It is expected that Otago exercise combined with AO training will be used as an intervention method in hospital treatment programs and the old people facilities for preventing falls in the old people.

Can action observation modulate balance performance in healthy subjects?

Background

Action observation activates brain motor networks and, if followed by action imitation, it facilitates motor learning and functional recovery in patients with both neurological and musculoskeletal disorders. To date, few studies suggested that action observation plus imitation can improve balance skills; however, it is still unclear whether the simple repetitive observation of challenging balance tasks is enough to modify postural control. Thus, the primary aim of this study was to investigate whether repetitive action observation of balance exercises without imitation has the potential to improve balance performance; the secondary aim was to estimate the different training effects of action observation, action observation plus imitation and balance training relative to a control condition in healthy subjects.

Methods

Seventy-nine healthy young adults were randomly assigned to 4 groups: action observation, action observation plus imitation, balance training and control. The first three groups were trained for about 30 minutes every day for three weeks, whereas the control group received no training. Center of pressure path length and sway area were evaluated on a force platform at baseline and after training using posturographic tests with eyes open and closed.

Results

As expected, both action observation plus imitation and balance training groups compared to the control group showed balance improvements, with a medium to large effect size performing balance tasks with eyes open. Action observation without imitation group showed a balance improvement with eyes open, but without a significant difference relative to the control group.

Conclusions

Both action observation plus imitation and balance training have similar effects in improving postural control in healthy young subjects. Future studies on patients with postural instability are necessary to clarify whether AOT can induce longer lasting effects. Action observation alone showed a trend toward improving postural control in healthy subjects, suggesting the possibility to study its effects in temporarily immobilized diseased subjects.

Effect of Group-Based Rehabilitation Combining Action Observation with Physiotherapy on Freezing of Gait in Parkinson's Disease

Freezing of gait (FoG) is among the most disabling symptoms of Parkinson's disease (PD) patients. Recent studies showed that action observation training (AOT) with repetitive practice of the observed actions represents a strategy to induce longer-lasting effects compared with standard physiotherapy. We investigated whether AOT may improve FoG and mobility in PD, when AOT is applied in a group-based setting. Sixty-four participants with PD and FoG were assigned to the experimental (AO) or control groups and underwent a 45-minute training session, twice a week, for 5 weeks. AOT consisted in physical training combined with action observation whereas the control group executed the same physical training combined with landscape-videos observation. Outcome measures (FoG questionnaire, Timed Up and Go test, 10-meter walking test, and Berg balance scale) were evaluated before training, at the end of training, and 4 weeks later (FU-4w). Both groups showed positive changes in all outcome measures at posttraining assessment. Improvements in FoG questionnaire, Timed Up and Go test, and Berg balance scale were retained at FU-4w evaluation only in the AOT group. AOT group-based training is feasible and effective on FoG and motor performance in PD patients and may be introduced as an adjunctive option in PD rehabilitation program.

Balance Training Reduces Brain Activity during Motor Simulation of a Challenging Balance Task in Older Adults: An fMRI Study

Aging is associated with a shift from an automatic to a more cortical postural control strategy, which goes along with deteriorations in postural stability. Although balance training has been shown to effectively counteract these behavioral deteriorations, little is known about the effect of balance training on brain activity during postural tasks in older adults. We, therefore, assessed postural stability and brain activity using fMRI during motor imagery alone (MI) and in combination with action observation (AO; i.e., AO+MI) of a challenging balance task in older adults before and after 5 weeks of balance training. Results showed a nonsignificant trend toward improvements in postural stability after balance training, accompanied by reductions in brain activity during AO+MI of the balance task in areas relevant for postural control, which have been shown to be over-activated in older adults during (simulation of) motor performance, including motor, premotor, and multisensory vestibular areas. This suggests that balance training may reverse the age-related cortical over-activations and lead to changes in the control of upright posture toward the one observed in young adults.

Age-Related Differences in Corticospinal Excitability during Observation and Motor Imagery of Balance Tasks

Postural control declines across adult lifespan. Non-physical balance training has been suggested as an alternative to improve postural control in frail/immobilized elderly people. Previous studies showed that this kind of training can improve balance control in young and older adults. However, it is unclear whether the brain of young and older adults is activated differently during mental simulations of balance tasks. For this purpose, soleus (SOL) and tibialis motor evoked potentials (MEPs) and SOL H-reflexes were elicited while 15 elderly (mean ± SD = 71 ± 4.6 years) and 15 young participants (mean ± SD = 27 ± 4.6 years) mentally simulated static and dynamic balance tasks using motor imagery (MI), action observation (AO) or the combination of AO and MI (AO + MI). Young subjects displayed significant modulations of MEPs that depended on the kind of mental simulation and the postural task. Elderly adults also revealed differences between tasks, but not between mental simulation conditions. Furthermore, the elderly displayed larger MEP facilitation during mental simulation (AGE-GROUP; F_(1,28) = 5.9; p = 0.02) in the SOL muscle compared to the young and a task-dependent modulation of the tibialis background electromyography (bEMG) activity. H-reflex amplitudes and bEMG in the SOL showed neither task- nor age-dependent modulation. As neither mental simulation nor balance tasks modulated H-reflexes and bEMG in the SOL muscle, despite large variations in the MEP-amplitudes, there seems to be an age-related change in the internal cortical representation of balance tasks. Moreover, the modulation of the tibialis bEMG in the elderly suggests that aging partially affects the ability to inhibit motor output.

Effects of Action Observation Therapy in Patients Recovering From Total Hip Arthroplasty Arthroplasty: A Prospective Clinical Trial

OBJECTIVE

The purpose of this study was to investigate the effectiveness of action observation therapy (AOT) compared with written information in patients submitted to a physical therapy program after primary total hip arthroplasty (THA).

METHODS

We conducted a prospective clinical trial. Twenty-four patients with THA, 62.5% female (aged 69.0 ± 8.5 years), received AOT in addition to conventional physical therapy (experimental group) or written information in addition to conventional physical therapy (exercise and information group) for 10 sessions. Outcomes used were visual analog scale, hip active and passive range of motion, Barthel Index, Short Form 36 (SF-36) Health Survey, Tinetti Scale, and Lequesne Index measurements. All measures were collected at baseline and at the end of the intervention. Repeated measures analysis of variance was used to examine the interventions effects within groups and between groups.

RESULTS

No relevant baseline differences were observed between groups. Both treatments produced statistically significant improvements on visual analog scale, active and passive range of motion, Barthel Index, SF-36, Tinetti Scale, and Lequesne Index immediately after the intervention (all, P < .001). SF-36 (physical functioning subscale) revealed a statistically significant intergroups difference (P = .02) after treatment.

CONCLUSIONS

Both treatments were effective at improving pain, functional status, quality of life, and gait features in patients with primary THA. In addition to conventional physical therapy, AOT improved perceived physical function more than written information.

TRIAL REGISTRATION IDENTIFIER

NCT02861638.

Effects of action observation treatment in recovery after total knee replacement: a prospective clinical trial

Objective:

We hypothesized that self-administered action observation treatment can increase the effectiveness of inpatient rehabilitation of patients after a primary total knee replacement.

Design:

A pilot randomized controlled trial.

Setting:

Thirty-one inpatients, admitted to our Physical and Rehabilitation Medicine Department.

Subjects:

After a primary total knee replacement were randomly assigned to either an experimental ( n=14) or control ( n=17) group.

Intervention:

All subjects received conventional physiotherapy and were required to perform additional self-administered exercises explained in a written informative brochure. Subjects in the experimental group were asked to watch a video showing a person exercising whilst the control group watched a nature video without exercises being shown.

Main outcomes measure:

Changes in Visual Analogue Scale, active and passive range of motion of knee, Barthel index, Short Form-36 Health Survey, Tinetti scale, Lequesne index measurements.

Results:

At the end of the intervention period, the increase of the active range of motion over the active flexion and extension in the experimental group was higher than in the control group; the difference between groups was 15.6° (95%CI 5.3–24.8) and 3.4° (95%CI 1.1–5.6), for active flexion and active extension respectively; between-group effect sizes were large at post-treatment period (d>1.3).

Conclusions:

adding action observation training to conventional inpatient physiotherapy is associated with a greater degree of recovery in patients who have undergone a primary total knee replacement.

Action observation training to improve motor function recovery: a systematic review

Following the discovery of Mirror Neuron System (MNS), Action Observation Training (AOT) has become an emerging rehabilitation tool to improve motor functions both in neurologic and orthopedic pathologies. The aim of this study is to present the state of the art on the use of AOT in experimental studies to improve motor function recovery in any disease. The research was performed in PubMed, PEDro, Embase, CINAHL and Cochrane Central Register of Controlled Trials (last search July 2015). Randomized controlled trials (RCTs) that analyse efficacy of AOT for recovery of motor functions, regardless of the kind of disease, were retrieved. The validity of the included studies was assessed using the Cochrane Collaboration tool for evaluating risk of bias. Twenty RCTs were eligible. Four studies showed AOT efficacy in improving upper limb functional recovery in participants with chronic stroke, two studies in sub-acute ones and one in acute ones. Six articles suggested its effectiveness on walking performance in chronic stroke individuals, and three of them also suggested an efficacy in improving balance. The use of AOT was also recommended in individuals with Parkinson's disease to improve autonomy in activities of daily living, to improve spontaneous movement rate of self-paced finger movements and to reduce freezing of gait. Other two studies also indicated that AOT improves upper limb motor function in children with cerebral palsy. The last two studies, showed the efficacy of AOT in improving motor recovery in postsurgical orthopedic participants. Overall methodological quality of the considered studies was medium. The majority of analyzed studies suggest the efficacy of AOT, in addition to conventional physiotherapy, to improve motor function recovery in individuals with neurological and orthopedic diseases. However, the application of AOT is very heterogeneous in terms of diseases and outcome measures assessed, which makes it difficult to reach, to date, any conclusion that might influence clinical practice.

Japanese elderly persons walk faster than non-Asian elderly persons: a meta-regression analysis

[Purpose] The purpose of this study was to clarify ethnic differences in walking speed by comparing walking speed in both Japanese and non-Asian elderly individuals and to investigate the necessity of consideration of ethnic differences in walking speed. [Subjects and Methods] Articles that reported comfortable walking speeds for community-dwelling elderly individuals were identified from electronic databases. Articles that involved community-dwelling individuals who were 60 years old or older and well functioning were included in the study. Articles that involved Asians were excluded. Weighted means for 5-m walking times were calculated as walking speeds from the Japanese and non-Asian sample data. The effects of age, gender, and ethnicity on 5-m walking times were then investigated using meta-regression analysis. [Results] Twenty studies (34 groups) were included for Japanese, and 16 studies (28 groups) were included for non-Asians. The weighted mean 5-m walking time was estimated to be 4.15 sec (95% confidence interval [CI]: 3.87-4.44) for Japanese and 4.24 sec (95% CI: 4.09-4.40) for non-Asians. Furthermore, using meta-regression analysis adjusted for age and gender, the 5-m walking time was 0.40 sec faster (95% CI: 0.03-0.77) for Japanese than for non-Asian elderly individuals. [Conclusion] Walking speed appeared faster for Japanese community-dwelling elderly individuals than for non-Asian elderly individuals.

Comparison of the effect of weight-bearing and non-weight-bearing positions on knee position sense in patients with chronic stroke

[Purpose] The purpose of this study was to investigate the knee joint proprioception in weight-bearing (WB) and non-weight-bearing (NWB) positions and to study the difference between the methods in chronic stroke patients. [Subjects and Methods] The subjects were 15 stroke patients who were randomly scheduled to perform both positions by a physical therapist not involved in the study. The subjects performed the positions (WB and NWB) based on a randomized controlled cross-sectional design. WB subjects were positioned in one-leg standing to assess the knee joint position sense. NWB subjects were instructed to sit comfortably in a chair and maintain the knees at 90° of flexion with the leg out of the plinth. [Results] The results revealed that the WB position showed a significant difference in knee position sense. The proprioception sense in the WB position was a higher than that in the NWB position. [Conclusion] The knee proprioception of chronic stroke patients differs between the weight-bearing and non-weight-bearing positions.

Frequency of provision of knowledge of performance on skill acquisition in older persons

The provision of feedback is a crucial factor for the evolution of the learner’s performance. It is known that the knowledge of performance has the function of guiding the learner’s attention to critical aspects of the movement pattern. The objective of this study was to examine the effect of frequency of knowledge of performance (KP) during the acquisition of the basketball free throw in older persons. Sixty active individuals (men and women) aged 60–69 years of age, divided into three experimental groups received KP in 100, 66, and 33% of their attempts during three practice sessions totaling 90 trials. The task was the basketball free throw. Volunteers were asked to conduct tests of immediate retention, 24 h retention, and 24 h transfer test, after the last practice session. During the acquisition phase, the volunteers received KP on the movement pattern on the previous attempt, which was obtained from a qualitative hierarchical checklist of the free throw (14 items). Sessions were recorded in order to confirm whether volunteers were able to score throughout sessions. ANOVA indicated that all individuals showed an improved performance in the retention and transfer tests. But the KP frequency of 66% was superior in both qualitative (movement pattern) and quantitative (score) measurements throughout the trials (p ≤ 0.05). In conclusion older persons seem to need an optimal KP frequency supply during the learning process.

Non-physical practice improves task performance in an unstable, perturbed environment: motor imagery and observational balance training

For consciously performed motor tasks executed in a defined and constant way, both motor imagery (MI) and action observation (AO) have been shown to promote motor learning. It is not known whether these forms of non-physical training also improve motor actions when these actions have to be variably applied in an unstable and unpredictable environment. The present study therefore investigated the influence of MI balance training (MI_BT) and a balance training combining AO and MI (AO+MI_BT) on postural control of undisturbed and disturbed upright stance on unstable ground. As spinal reflex excitability after classical (i.e., physical) balance training (BT) is generally decreased, we tested whether non-physical BT also has an impact on spinal reflex circuits. Thirty-six participants were randomly allocated into an MI_BT group, in which participants imagined postural exercises, an AO+MI_BT group, in which participants observed videos of other people performing balance exercises and imagined being the person in the video, and a non-active control group (CON). Before and after 4 weeks of non-physical training, balance performance was assessed on a free-moving platform during stance without perturbation and during perturbed stance. Soleus H-reflexes were recorded during stable and unstable stance. The post-measurement revealed significantly decreased postural sway during undisturbed and disturbed stance after both MI_BT and AO+MI_BT. Spinal reflex excitability remained unchanged. This is the first study showing that non-physical training (MI_BT and AO+MI_BT) not only promotes motor learning of “rigid” postural tasks but also improves performance of highly variable and unpredictable balance actions. These findings may be relevant to improve postural control and thus reduce the risk of falls in temporarily immobilized patients.

The effects of action observational training on walking ability in chronic stroke patients: a double-blind randomized controlled trial

Objective:

To investigate the effect of action observational training on walking ability with chronic stroke patients.

Design:

A double-blind randomized controlled trial.

Setting:

Inpatient rehabilitation hospital.

Participants:

Thirty chronic stroke patients.

Interventions:

Patients in both groups underwent treadmill training for 30 minutes. The action observational training group ( n = 15) watched a video of treadmill walking actions taken at various speeds before treadmill training for 10 minutes. The control group ( n = 15) watched a nature video unrelated to gait training for the same amount of time. All participants received training five times a week for a period of four weeks.

Main measures:

Timed up and go test, 10-metre walk test, 6-minute walk test and maximal flexed knee angle in the swing phase during walking.

Results:

There were significant improvements in timed up and go test (–4.47 vs. –2.47 seconds), 10-m walk test (0.35 vs. 0.16 m/s), 6-minute walk test (93.13 vs. 32.53 m) and maximal flexed knee angle in the swing phase during walking (7.11 vs. 4.58 degrees) in the action observational training group compared with the control group ( P < 0.05). Small to huge effect sizes of 1.27, 0.57, 2.34 and 0.37 were observed for timed up and go test, 10-m walk test, 6-minute walk test, and maximal flexed knee angle in the swing phase during walking, respectively.

Conclusion:

These results suggest that action observational training is an effective method for improvement of the walking ability in chronic stroke patients.

A study of analysis of the brain wave with respected to action observation and motor imagery: a pilot randomized controlled trial

[Purpose] The purpose of this study was to compare the effects of action observation training and motor imagery training on recovery from chronic stroke. [Subjects] Thirty patients (who were over six months post stroke) participated in this study and were randomly allocated to three groups. [Methods] The action observation training group practiced additional action observation training for five 30-minute sessions over a four-week period. The motor imagery training group practiced additional motor imagery training for five 30-minute sessions over a four-week period. Electroencephalogram were used to compare brain waves between the three groups. [Results] The action observation group showed significant changes in relative alpha power in Fp1 and Fp2 and relative beta power in Fp2 and C3. [Conclusion] Action observation induces higher levels of cognitive activities than motor imagery and physical training. Action observation is expected to be more effective for stroke patients.

Skills learning in robot-assisted surgery is benefited by task-specific augmented feedback

BACKGROUND

Providing augmented visual feedback is one way to enhance robot-assisted surgery (RAS) training. However, it is unclear whether task specificity should be considered when applying augmented visual feedback.

METHODS

Twenty-two novice users of the da Vinci Surgical System underwent testing and training in 3 tasks: simple task, bimanual carrying (BC); intermediate task, needle passing (NP); and complex task, suture tying (ST). Pretraining (PRE), training, and posttraining (POST) trials were performed during the first session. Retention trials were performed 2 weeks later (RET). Participants were randomly assigned to 1 of 4 feedback training groups: relative phase (RP), speed, grip force, and video feedback groups. Performance measures were time to task completion (TTC), total distance traveled (D), speed (S), curvature, relative phase, and grip force (F).

RESULTS

Significant interaction for TTC and curvature showed that the RP feedback training improved temporal measures of complex ST task compared to simple BC task. Speed feedback training significantly improved the performance in simple BC task in terms of TTC, D, S, curvature, and F even after retention. There was also a lesser long-term effect of speed feedback training on complex ST task. Grip force feedback training resulted in significantly greater improvements in TTC and curvature for complex ST task. For the video feedback training group, the improvements in most of the outcome measures were evident only after RET.

CONCLUSIONS

Task-specific augmented feedback is beneficial to RAS skills learning. Particularly, the RP and grip force feedback could be useful for training complex tasks.

Interhemispheric inhibition during mental actions of different complexity

Several investigations suggest that actual and mental actions trigger similar neural substrates. Yet, neurophysiological evidences on the nature of interhemispheric interactions during mental movements are still meagre. Here, we asked whether the content of mental images, investigated by task complexity, is finely represented in the inhibitory interactions between the two primary motor cortices (M1s). Subjects' left M1 was stimulated by means of transcranial magnetic stimulation (TMS) while they were performing actual or mental movements of increasing complexity with their right hand and exerting a maximum isometric force with their left thumb and index. Thus, we simultaneously assessed the corticospinal excitability in the right opponent pollicis muscle (OP) and the ipsilateral silent period (iSP) in the left OP during actual and mental movements. Corticospinal excitability in right OP increased during actual and mental movements, but task complexity-dependent changes were only observed during actual movements. Interhemispheric motor inhibition in the left OP was similarly modulated by task complexity in both mental and actual movements. Precisely, the duration and the area of the iSP increased with task complexity in both movement conditions. Our findings suggest that mental and actual movements share similar inhibitory neural circuits between the two homologous primary motor cortex areas.

The Effect of Passive Listening versus Active Observation of Music and Dance Performances on Memory Recognition and Mild to Moderate Depression in Cognitively Impaired Older Adults

The study examined the effects of music therapy and dance/movement therapy on cognitively impaired and mild to moderately depressed older adults. Passive listening to music and active observation of dance accompanied by music were studied in relation to memory enhancement and relief of depressive symptoms in 100 elderly board and care residents. The Beck Depression Inventory and the Recognition Memory Test–Faces Inventory were administered to two groups (one group exposed to a live 30-min. session of musical dance observation, the other to 30 min. of pre-recorded music alone) before the intervention and measured again 3 and 10 days after the intervention. Scores improved for both groups on both measures following the interventions, but the group exposed to dance therapy had significantly lower Beck Depression scores that lasted longer. These findings suggest that active observation of Dance Movement Therapy could play a role in temporarily alleviating moderate depressive symptoms and some cognitive deficits in older adults.